Intraocular pressure following combined routes of bevacizumab-augmented trabeculectomy for refractory neovascular glaucoma.

PURPOSE: To evaluate the intraocular pressure (IOP) control following combined routes of adjuvant bevacizumab with trabeculectomy in refractory neovascular glaucoma.

METHODS

From June 2011 to December 2011, 5 consecutive cases of neovascular glaucoma with persistent raised IOP on maximal medical treatment underwent adjuvant bevacizumab by combined routes (subconjunctival (SC) and/or intracameral (IC), intravitreal (IV) injections) before pan-retinal photocoagulation (PRP). Needs for repeat procedures or medications for IOP control over the postoperative period were assessed.

RESULTS

The mean IOP (1 SC, 1 IC + IV, 3 SC + IC routes) reduced from 40 ± 5.5 mm Hg to 17 ± 3.7 mm Hg at a mean final follow-up of 4 ± 3.7 months (range 1-9 months), respectively (p < 0.001 for each). All eyes had transient IOP spikes 1-3 months after surgery, which normalized spontaneously after PRP, while one eye required topical medications for IOP control.

CONCLUSIONS

Combined routes of adjuvant bevacizumab augmented trabeculectomy may help in better IOP control (IC + IV > IC + SC > SC) in refractory neovascular glaucoma but require additional procedures for sustained effect.